January 6 Town Hall Q + A
The following Town Hall questions were answered with information that was current at the time. Information around COVID-19 and our response continues to evolve. If you are unsure if the information below is still current, or if you can’t find the information elsewhere on the website, please talk to your leader or email: COVIDfirstname.lastname@example.org
General immunization information can be also found here.
Please note: due to the number of questions asked, we have consolidated some questions.
- When will I get vaccinated?
- Vaccine is being administered through a phased approach developed by the Ministry of Health, starting with priority groups first. Sequencing of these groups is based on recommendations from the National Advisory Committee on Immunization (NACI) and on our own epidemiological data to reduce the risk of infection to those most vulnerable to severe disease and death following COVID-19 infection, and to protect our health care system. This includes residents and all staff working in long-term care, as well as health-care workers in certain acute care settings providing care for COVID-19 patients. More vaccine arrives every week, and we know and appreciate that health care workers in PHC are among the initial priority groups for vaccination in the coming weeks, so be assured that all who want to be vaccinated, will be vaccinated, as soon as possible.
- How will I be notified when it’s my turn to be vaccinated?
- Your manager, supervisor, medical department head, or director of care will notify you when it’s your turn to be vaccinated. You will also receive an email notification via your PHC email address. If you work off-site, please ensure your contact information is up to date with current email address and phone number.
- What’s the verification process to ensure PHC staff getting vaccinated are eligible?
- When staff arrive at a PHC clinic, we are asking what unit/department they work in to ensure they are eligible. We are trusting that staff are being truthful in their responses.
- Will all staff in my priority area get the vaccine regardless of their job title?
- Yes, everyone will receive the vaccine based on the areas they work, regardless of their title.
- Given the recent comments by Dr. Evan Adams, will self-identified Indigenous staff at PHC be prioritized to receive the vaccine?
- Public Health determines the order of vaccination, so if they identify Indigenous staff as a priority group, we would follow that direction.
- Federal government has introduced national compensation program for vaccine injuries. If I’m pregnant but I sign consent for the vaccine, will I receive compensation?
- Staff are recommended to research the government programmes to determine if they fit the criteria for compensation.
- If I am on mat leave, will my manager still be reaching out to me for vaccination or am I considered part of the general public and vaccinated according to age?
- We are awaiting instruction from Public Health regarding staff on maternity leave.
- I work for Providence but in Fraser Health - where do I take direction on getting vaccinated?
- Both Providence and Fraser Health staff are taking direction on the vaccine rollout from the provincial government and when it’s your turn to get vaccinated, you will hear about it from your leader. If you have any questions about your vaccine eligibility, please talk to your leader or email: COVIDemail@example.com
- Is it safe to wait more than 21 days for my second dose?
- In December, Dr. Bonnie Henry, Provincial Health Officer, explained the decision to extend the interval between doses for people in B.C. From looking at data, modelling from BC Centre for Disease Control, and using the COVID-19 Ethical Decision-Making Framework, it has been determined that administering the first doses of vaccine to as many people as possible in the priority groups in the early weeks of the campaign, when doses are limited, will protect the greatest number of at-risk people overall in the shortest possible time, and will have the greatest impact on reducing mortality, severe disease, and hospitalizations. Based on direction from the Ministry of Health, we will be planning to provide the second dose of both the Pfizer and Moderna vaccines at approximately 35 days after the first dose. You will be invited to receive your second dose just as you were for your first, once we have ensured the other priority groups have had their first dose as well.
For more on the data from the study around the efficacy of the vaccine and waiting after 21 days, please watch Dr. Victor Leung’s presentation from the January 6 Town Hall (15:40 -24:40): https://nexuswebcast.mediasite.com/Mediasite/Play/4860902f85b448bf88bcdaea36b6c92f1d
- Does the vaccine work for the UK variant of the virus?
- We don’t know the definitive answer to this yet, but early reports suggest that with these variants the vaccine is equally protective.
- Will I be forced to get the vaccine in order to work?
- While we are waiting for the guidelines from Public Health, staff have historically always had a choice in getting immunized.
Regardless of the vaccine, you are still expected to follow PPE procedures.
- Will those who have had COVID be offered the vaccine? Can they get tested for antibodies?
- The vaccine can be given to those who have had a previous COVID infection. However, the decision in BC is to have those individuals wait until a later phase. In those individuals who have had infection, there are also those who may not develop the robust immune response. For testing, we don't have the capacity to measure neutralizing antibodies at a large scale to check everyone to see if they've been at least had neutralizing antibodies before getting the vaccine.
- Will Allied Health staff (PT, OT, etc.) at SPH and MSJ be included in the first round of vaccination? We usually have to cover areas like ED/ICU on weekends.
- We will get this group vaccinated as soon as we can. For this first wave, one of the first areas of focus have been those that work in the ED, ICU and COVID units on a full-time basis. This group will be covered next, however, we are unsure on the timing as it depends on vaccine quantities and prioritizing other groups. PHC is a big organization and we are rationing the vaccine until we get more.
- After the second dose and we have (almost) full immunity, is it possible to still be a carrier of the virus without our immune system being affected itself?
- While vaccination is very effective in preventing symptomatic COVID-19, it is not yet known if vaccine recipients can still acquire the virus without symptoms and transmit is to others. Until more is more data is available, vaccine recipients must continue to use PPE while at work.
- Once I received both doses of the vaccine, am I quarantine-free for traveling?
- Currently, the requirements in Canada for quarantining after travel have not changed. For travelling to other countries, this depends on the country you are travelling to; every country makes its own rules about their quarantine requirements.
- Will we need to get COVID vaccinations every year? Will there be a “COVID season” like the flu season every year?
- We currently don’t have enough data; however this will depend on if the virus mutates, and how the vaccines respond, to determine if repeat dosing will be necessary. One of the advantages of these new mRNA vaccines is how much easier it is to alternate them. So for example when you get new COVID variants, it should be relatively quick to manufacture a vaccine to potentially contain more than one variant for which you now need to immunize the population against.
- Will the AstraZeneca/Oxford vaccine be recommended for pregnant people?
- Pregnant women were excluded from the AstraZeneca/Oxford vaccine trial, so recommendations are likely to be similar to the Moderna and BioNTech recommendations.
- What if I get my first vaccine dose, then get pregnant. Should I get the second dose? Do I have to wait until after the baby is born and get first dose again?
- The Pfizer-BioNTech and Moderna trials did not include pregnant women, however, there were people who got pregnant during the study and no untoward effects have been found. Studies from Canada and internationally have found that COVID-19 infection in pregnancy is associated with a high rate of hospitalization (9-11%) and ICU admissions (2-4%).
While neither vaccine is approved for use in pregnant women, the Society of Obstetricians and Gynecologists of Canada’s consensus statement from January 4, 2020 states that “women who are pregnant or breastfeeding should be offered vaccination at anytime if they are eligible and no contraindications exist. This decision is based on the woman’s personal values and an understanding that the risk of infection and/or morbidity from COVID-19 outweighs the theorized and undescribed risk of being vaccinated during pregnancy or while breastfeeding. Women should not be precluded from vaccination based on pregnancy status or breastfeeding.”
The BCCDC recommends that those who are pregnant talk with their health care provider to make a decision on whether to receive the vaccine. For some people, the risk of being infected with COVID-19 may outweigh any potential risk associated with receiving a COVID-19 vaccine.
- Should pregnant/breastfeeding acute health care workers take the vaccine?
- It's a matter of an informed decision. There is no current evidence in those groups because pregnant women weren't included in the studies, so it becomes a matter of discussing whether or not the risks of potentially becoming infected with COVID outweigh the benefits.
Most of the societies that specialize in obstetrics and gynecology, both American and Canadian, have recommended that the risks of a problem are low as far as we know.
- Polyethylene glycol is thought to cause to allergic reactions to the vaccines. PeG was previously deemed unsafe in vaping juice. Why is it safe for use now?
- Polyethylene glycol is used widely in food, cosmetics and pharmaceuticals. It's uncommonly associated with allergic reactions. As for it being used in vaping, because of the high temperatures at which some of the substances are vaped there appears to be some sort of physiological issue with that causing these unusual insert interstitial pneumonias.
- Could it be dangerous for the elderly to receive the vaccines because they generally have lower immunity?
- Elderly populations were included in both the Pfizer and Moderna trials with similar adverse events to those seen in younger populations.
- I've heard that vaccines are not as effective in elderly. Is this true?
- The Moderna and Pfizer-BioNTech trials included adults from a range of ages, and both studies found that the vaccine showed similar efficacy in elderly populations to what was seen in younger age ranges.
- Is it safe for staff with psoriasis taking cyclosporine ormethotrextate to get the vaccine? Is it effective?
- The Pfizer-BioNTech and Moderna studies did not include people treated with immunosuppressive medications such as cyclosporine or methotrexate. Therefore, we do not have information on the safety or efficacy of the vaccine for people on these treatments.
As the vaccine is a non-live vaccine, there is no risk of becoming infected with COVID-19 from the vaccine. People on these medications should talk with their health care provider to make a decision on whether to receive the vaccine at this time. For some people, the risk of being infected with COVID-19 may outweigh any potential risk associated with receiving a COVID-19 vaccine.
- Must the first and second dose be the same brand?
- We don’t have data available on mixing manufacturers of vaccines, and this hasn’t been mentioned as part of the current vaccination program.
There are trials being designed to look at combinations of vaccines. Until that data is available, unlikely anyone in vaccinology would support this. At minimum, that is why we need to have a robust records system.
- Is it true that the side effects are worse for the second dose?
- According to the Moderna and Pfizer-BioNTech trials, systemic side effects such as fever were more frequently seen after the second dose. Reassuringly, the incidence of serious adverse events was low in both vaccines.
- Does efficacy of the vaccine drop after a certain time period?
- The duration of efficacy for the Pfizer-BioNTech and Moderna vaccines is unknown at this time.
- How effective are mRNA vaccines when it only produce IgG antibody in the blood, and not IgA in the lung?
- While IgA antibodies are important for mucosal immunity, IgG also provides important protection against infection at mucosal sites, in particular in the lung. We don’t know what the effect of these vaccines are on IgA or IgG levels in the lung because these were not measured in the trials. IgG levels in the blood, however, were measured, and studies from other respiratory viruses (such as influenza and RSV) have shown that neutralizing antibody levels in the blood are useful correlates of protection against these viral infections.
- Can mRNA vaccines trigger multi-organ fibrosis in a year or two?
- There is currently no evidence to suggest these vaccines will trigger multi-organ fibrosis. The vaccine is delivered to the deltoid muscle and is processed by immune cells in the muscle and in nearby draining lymph nodes, leading to the activation and generation of protection against the spike protein found on the SARS-CoV2 virus. This provides a controlled way of becoming immune to the virus compared to natural infection with SARS-CoV2, which carries significant risks of severe illness and widespread inflammation. While we do not have two-year safety data at this time for the Pfizer-BioNTech and Moderna mRNA vaccine, clinical studies on mRNA vaccines targeting other viruses that began more than 2 years ago have not reported fibrosis.
- I have an anaphylactic reaction to peanuts; should I avoid getting the vaccine?
- People with a history of allergy that is unrelated to the COVID-19 vaccine or its components can receive the COVID-19 vaccine without any special precautions. As for the routine administration of all vaccines, they should be administered in a health care setting capable of managing anaphylaxis, and individuals should be observed for a minimum of 15-30 minutes following vaccination. Individuals with a suspected allergy to a COVID-19 vaccine or any of its components should be evaluated by an allergist before receiving the vaccine.
- Is there any data regarding eosinophil-related pathology/response due to immunopotentiation secondary to the vaccine?
- To date there is no evidence of vaccine associated enhanced disease or immunopathology related to the approved COVID-19 vaccines.
- Are there plans to expand the OHS team more during this pandemic? So that fit testing sessions and contact tracing can be offered in hospital.
- The team has been expanding to meet the demands for fit testing. Contact tracing is a public health function.
- Are more vaccinators needed? Some of us can volunteer to help.
- We will be getting volunteers and we will be expanding this program because we're in here for the long term to do all these immunizations. More communications will be forthcoming and please tell your manager if you’re interested. Please email COVIDfirstname.lastname@example.org if you would like to get involved.
- What vaccine studies can we participate in to support continuing to develop the science, ie long term immunity, populations with limited data, ongoing monitoring?
- Staff who provide care at long-term care facilities operated by Providence Health Care and who have not yet received their first vaccination dose are invited to participate in a study that seeks to understand immune responses to COVID-19 vaccines. Learn more here.
Other vaccine study opportunities will be communicated as they arise. Staff may also check The Vaccine Evaluation Center for research opportunities.
- If you can from work from home, should you continue to work from home?
- Providence has made no changes to staff that are working from home at this moment. If this continues to be an ideal situation between the manager and staff, then please continue to do so. We will be formally rolling out our working remote policy this month and will more information will be forthcoming.
While the vaccine is good news, it will still be a while before it impacts community transmission and we need to continue to do all the things that we have been doing, including working from home, where applicable.